Caitlin Marie Bonneville, RN, BSN

Individual provider Active NPI Registered Nurse · Leicester, MA

NPI 1689197840 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1689197840
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN2305696 (MA)
Practice address
184 Rawson St
Leicester, MA 01524-2018
Phone
(774) 287-1874
NPI assigned
Jul 19, 2017
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2305696MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Live Your Life Healthcare LLC Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2305696 MA Yes

Addresses

Primary practice location

184 Rawson St
Leicester, MA 01524-2018

Mailing address

184 Rawson St
Leicester, MA 01524-2018
Phone (774) 287-1874

Other providers in Leicester, MA

All providers in Leicester, MA · Registered Nurse in Massachusetts

Sources for this page

Verify at the official NPI Registry.